In this study, the effect of low-intensity pulsed ultrasound (LIPUS) on cartilage was evaluated in a rat osteoarthritis (OA) model using serum biomarkers such as CTX-II (type II collagen degradation) and CPII (type II collagen synthesis) as well as histological criteria (Mankin score and immunohistochemical type II collagen staining). OA was surgically induced in the knee joint of rats by anterior cruciate/ medial collateral ligament transection and medial meniscus resection (ACLT þ MMx). Animals were divided into three groups: shamoperated group (Sham), ACLT þ MMx group without LIPUS (ÀLIPUS), and ACLT þ MMx group with LIPUS (þLIPUS; 30 mW/cm 2 , 20 min/ day for 28 days). CTX-II levels were elevated in both ÀLIPUS and þLIPUS groups compared to that in the Sham group after the operation, but there was no significant difference between þLIPUS and ÀLIPUS groups, suggesting that LIPUS does not affect the degradation of type II collagen in this model. In contrast, CPII was significantly increased in þLIPUS group compared to ÀLIPUS and Sham. Moreover, histological damage on the cartilage (Mankin score) was ameliorated by LIPUS, and type II collagen was immunohistochemically increased by LIPUS in the cartilage of an OA model. Of interest, mRNA expression of type II collagen was enhanced by LIPUS in chondrocytes. Together these observations suggest that LIPUS is likely to increase the type II collagen synthesis in articular cartilage, possibly via the activation of chondrocytes and induction of type II collagen mRNA expression, thereby exhibiting chondroprotective action in a rat OA model. ß
Cerebral ischemic cellular swelling occurs primarily in astrocytes. This water influx into the intracellular space is believed to result from osmotic water movement after disruption of membrane ionic homeostasis. However, cellular swelling occurs earlier than expected after ischemia and new ionic and water channels have been discovered. This study examined the temporal profile of the water and ionic movement across the cell membrane after global ischemia by measuring the changes in extracellular space (ECS), extracellular K(+) and Na(+) ion concentrations ([K(+)](e) and [Na(+)](e)) using a high resolution tissue impedance probe and ion selective micropipettes in the rat cortex. The effect of mild cerebral hypothermia (31.5 +/- 2.6 degrees C brain temperature) on these parameters was also examined. The ECS started to decrease at 34 +/- 8 sec after global ischemia and reached half the maximum change at 61 +/- 17 sec. [K(+)](e) started to increase initially at 33 +/- 11 sec (phase 1) and then increased rapidly at 62 +/- 25 sec (phase 2), and [Na(+)](e) started to decrease at 88 +/- 27 sec after ischemia. With mild hypothermia, the ECS started to decrease at 75 +/- 35 sec after ischemia and reached half the maximum change at 123 +/- 44 sec, [K(+)](e) started to increase initially at 80 +/- 24 sec (phase 1) and then increased rapidly at 120 +/- 32 sec (phase 2), and [Na(+)](e) started to decrease at 172 +/- 70 sec. The present study shows that ischemic cellular swelling (decreased ECS) occurs concomitantly with the phase 1 increase of [K(+)](e) but precedes the disruption of ionic membrane homeostasis (phase 2). Mild hypothermia prolongs the onset of these phenomena but does not affect the magnitude of the changes in ECS and ion concentrations.
-Background: Although surgeons must perform implantation of the cementless stem during total hip arthroplasty (THA) without complications, assessment is left to the surgeon's intuitive judgement, which could contain inter/intra-observer bias variety. We therefore asked (1) whether the sound created during the stem implantation could be evaluated objectively and (2) whether those sounds are correlate to the complication specific to the cementless stems. Our hypothesis is that the sounds produced during stem insertion could be quantified and related to the complications. Patients and method: In 71 THAs, we quantified the sound produced during stem insertion and investigated the relationship between these sounds and the occurrence of intraoperative fracture and subsidence. Results: The sound data were divided into two patterns: Patterns A and B. The difference between the peak value (dB) at the most common frequency (near 7 kHz) and the second most common frequency (near 4 kHz) of strikes during the final phase of implantation in Patterns A and B showed a significant difference. Adverse events on intraoperative fracture and subsidence were significantly less common in patients with Pattern A than in those with Pattern B (six of 42 hips with Pattern A and 13 of 29 hips with Pattern B, p = 0.004). Pattern A in predicting a clinical course without those adverse events was 69.2% and the specificity was 68.4%. Positive and negative predictive values were 85.7% and 44.8%, respectively. Conclusion: The sound generated during stem insertion was quantified. Those sound patterns were associated with complications.
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